Acne vulgaris is a common cutaneous multifactorial disease spread worldwide and caused by hormonal, microbiological and immunological mechanisms. Acne is characterized by open and closed comedones (blackheads and whiteheads) and inflammatory lesions like papules, pustules and nodules. Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acnes are the organisms which proliferate rapidly and cause development of acne. The severity of this skin disorder generally increases with age and time. People normally get affected by it with the onset of puberty affecting both physical & psychological levels and therefore may constitute a cause of concern for treating physicians.
Acne affects all age groups i.e. 85% of teenagers, about 8% in 25-34 year olds and 3% in 35-44 year olds. Although it is not a life threatening disease, it is a distressing skin condition which causes significant psychological disability. Moreover, teenagers or young adults often experience the development of scar and scarring may affect up to 95% of the patients having acne.
There is a large and expanding market for over-the-counter (OTC) medications against acne. The estimated annual worldwide expenditure on acne OTC medication is $100 millions. The long term treatment of the present synthetic drugs comprising antibiotics and chemotherapeutic agents either inhibit excess sebum production, follicular hyperkeratinisation disorders, cytokines, reactive oxygen species and proliferation of P. acnes within the follicle. These drugs are applied either topically or taken orally for the treatment of acne.
The therapeutic success in the treatment of acne is highly dependent on the regular application of topical agents over a prolonged period of time. However the disadvantages associated with the existing topical therapies defeat the purpose of the treatment and make it patient-noncompliant. Currently available treatment for acne is based on antibiotics and retinoids. The use of antibiotics have lot of limitations due to the development of resistance by bacteria and their untoward side effects, such as skin dryness, pruritis, burning sensation, erythema, occasional hyper pigmentation, local irritation and photosensitization reactions. Furthermore, retinoids are highly teratogenic.
Also, extracts from plants and specific compounds obtained from plant sources are often used in cosmetic and pharmaceutical compositions. European Patent Application Publication No. 0 870 507 describes a synergistic antibacterial composition that includes an extract of botanical materials and an essential oil. The essential oil is described as having anti-microbial activity, whereas the extract of botanical materials has significantly lower activity, or no anti-microbial activity, when used alone.
Therefore alternative treatments of acne using natural products must be studied and developed. This creates a great interest in development of a topical formulation containing natural extracts possessing antibacterial effect to treat acne such as the development of present invention.
Nosocomial infections are hospital-acquired infections (HAI) or healthcare-acquired infections whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. In the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms (i.e. bacteria), combined, cause or contribute to 99,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to treat with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital.
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several difficult-to-treat infections in humans. MRSA is any strain of Staphylococcus aureus that has developed, through resistance to beta-lactam antibiotics, such as the penicillin-types (methicillin, dicloxacillin, oxacillin, etc.) and the cephalosporins. This resistance makes MRSA infection more difficult to treat with standard types of antibiotics and thus more dangerous.
MRSA is especially troublesome in hospitals, prisons, and nursing homes, where patients with open wounds, invasive devices, and weakened immune systems are at greater risk of nosocomial infection than the general public. MRSA began as a hospital-acquired infection, but has developed limited endemic status and is now sometimes community-acquired.
Dogs can be carriers of MRSA and may be otherwise perfectly healthy. This is referred to as colonization. Though dogs are not normally colonized with MRSA, they can be exposed to a person that is colonized or who has an active infection, and therefore can become infected or colonized as well.
Staphylococcus intermedius is a common species of bacteria found in rabbits and is called Staphylococcus pseudintermedius when found in dogs. A small percentage of animals may develop skin infections caused by methicillin-resistant—Staphylococcus intermedius (MRSI) or—Staphylococcus pseudintermedius (MRSP), both infections being difficult to get rid of, and often require aggressive topical therapies.